Cold exposure
What is it: Brief, medically supervised extreme cold sessions to reduce inflammation.- ⬤ Minimal research: Very little scientific study exists, with no or very few peer-reviewed studies. Insufficient data for conclusions.
- ⬤⬤ Limited research: Few studies exist, mostly small trials or case reports. Findings are preliminary and lack strong validation.
- ⬤⬤⬤ Moderately researched: Multiple studies, including mid-sized trials, exist. Some findings are replicated, but more research is needed.
- ⬤⬤⬤⬤ Well-researched: Supported by substantial evidence, including at least one large trial or meta-analysis.
- ⬤⬤⬤⬤⬤ Extensively studied: Numerous large studies and meta-analyses exist. Findings are widely accepted with strong scientific consensus.
- ⬤ Extremely Difficult to Access: Rare, experimental, or highly specialized. Requires multiple referrals, long wait times, travel, and strict follow-up.
- ⬤⬤ Difficult to Access: Limited to select centers with moderate barriers. Requires referral, potential travel, and wait times of weeks to months.
- ⬤⬤⬤ Moderately Accessible: Available in larger hospitals or clinics. Requires a basic referral, with moderate wait times and some coordination.
- ⬤⬤⬤⬤ Easy to Access: Widely available in most clinics. Minimal referral, short wait times, and simple preparation or follow-up.
- ⬤⬤⬤⬤⬤ Trivial to Access: Easily found in pharmacies or clinics. No referral needed, minimal wait, and straightforward access.
- ⬤ Up to $100
- ⬤⬤ Up to $500
- ⬤⬤⬤ Up to $2000
- ⬤⬤⬤⬤ Up to $10,000
- ⬤⬤⬤⬤⬤ More than $10,000
To calculate the reported effectiveness for a patient view, the model first analyses whether it can be ascertained that the person writing the review has had direct experience of the treatment for themselves or a loved one. If so, it then uses sentiment analysis to rate their view from 1-5 on how effective this treatment was for them, with 1 being the least effective, and 5 the most effective.
9 Resources
Referenced in this guide
4 Research papers
Referenced in this guide
9 Expert views
Contributed in this guide
50 Patient views
Contributed in this guide
Figure out what Cold exposure means for you
Page contents
Basics: What you need to know
This formalized whole‐body cryotherapy protocol for Long COVID involves very short exposure to extremely cold temperatures, typically between −110°C and −140°C, within a specialized chamber under strict medical supervision. By targeting inflammation and modulating the autonomic nervous system, this treatment aims to help manage chronic symptoms linked to Long COVID, though it differs significantly from casual cold exposure like showers or outdoor climate.
History and development
- Origins in Japan: Whole-body cryotherapy was first introduced by Dr. Toshima Yamaguchi in 1978 to manage rheumatoid arthritis-related inflammation.
- Rapid sports adoption: Professional athletes recognized its potential for muscle recovery, leading to further development of specialized cryotherapy chambers.
- Extension to chronic conditions: As interest grew, researchers began investigating its impacts on new areas such as post-viral syndromes, including Long COVID, particularly focusing on inflammation.
What is known
- Anti-inflammatory effects: Studies suggest that short bursts of extremely cold temperatures can lower inflammatory markers, which may benefit people experiencing persistent discomfort.
- Autonomic recalibration: The controlled shock from cold exposure can stimulate the autonomic nervous system, potentially helping individuals with dysautonomia, a common symptom of Long COVID.
- Session specifics: Typical sessions last 2–3 minutes. During this time, the body triggers skin blood vessel constriction, followed by rapid rewarming that might support circulation.
- Secondary benefits: Some users report improvements in mood, sleep quality, and stress management—possibly linked to endorphin release and short-term analgesic effects.
- Potential risks: Individuals with certain cardiac or respiratory vulnerabilities may find the extreme cold temperatures challenging or even symptom-aggravating.
What is not known
- Long-term impacts: The effects of repeated cryotherapy sessions on Long COVID symptoms over months or years remain insufficiently researched.
- Optimal protocols: The best frequency, duration, and temperature ranges for effectively supporting post-viral symptoms are still under investigation.
- Mechanistic details: While inflammation reduction is a target, the precise biological pathways by which cryotherapy might improve Long COVID symptoms are not fully mapped out.
- Regulated subzero: Participants enter a chamber cooled to around −110°C to −140°C for a brief interval.
- Rapid vasoconstriction: Extreme cold causes blood vessels to constrict, reducing local inflammation.
- Endorphin surge: The body may release endorphins as a stress response, aiding in pain relief.
- Autonomic reset: Short sessions can trigger autonomic shifts that may help with symptom regulation.
- Gradual rewarming: After exiting the chamber, blood vessels expand, which can support circulation and recovery.
- Cardiovascular strain: Rapid temperature shifts can stress the heart.
- Skin irritation: Improper procedure or chamber malfunction can cause frostbite or dryness.
- Respiratory discomfort: Extreme cold air may irritate airways in susceptible individuals.
- Potential anxiety: Some individuals may find the intense cold environment distressing.
- Unclear efficacy: Some clinicians question the limited data on long-term benefits.
- Research hurdles: Others argue that controlled trials involving cryotherapy for post-viral conditions are still emerging.
- Cost and access: High setup costs and specialized equipment limit its availability.
- Placebo considerations: Critics note that perceived improvements could be partly from placebo effects.
Patient views
Experiences
- Patients appreciate the temporary relief from fatigue and pain.
- Many find cold exposure refreshing and calming.
- Some report improved heart rate and reduced stress.
- It's a free and accessible treatment option.
Challenges
- Cold exposure can trigger post-exertional malaise (PEM).
- Some find it mentally challenging to start cold therapy.
- Others experience heightened sensitivity to cold temperatures.
- It may not work for everyone or provide lasting benefits.
Tips
- Start with short durations and gradually increase exposure.
- Avoid cold therapy during periods of heightened pain.
- Combine cold exposure with rest for better results.
- Monitor your body's response and adjust accordingly.
To calculate the reported effectiveness for a patient view, the model first analyses whether it can be ascertained that the person writing the review has had direct experience of the treatment for themselves or a loved one. If so, it then uses sentiment analysis to rate their view from 1-5 on how effective this treatment was for them, with 1 being the least effective, and 5 the most effective.
Patient view
Does hot / cold exposure fit into this category? I find warm baths and cold showers helpful. So get back into hot bath after a spell under cold shower, or alternate hot/cold in the shower. I was told by a pain physio that it's not advised whilst in pain, so good for fatigue and other symptoms, if you're able to move/pacing needs etc.
August 2024 • Turnto Comment
Patient view
Hi there Cold rinses at the end of warm showers really help my symptoms for a few hours after. I think it's important to start small and build up tolerance. It is a stress to the system (the cold shock) but the reduction in pain/weakness/fatigue is worth it! And something free to try. Good luck 👍
November 2024 • Turnto Comment
Expert views
What they liked
- Experts appreciate cold exposure's ability to reduce inflammation and improve nervous system function.
- It can enhance stress resilience and cortisol response, aiding energy and mood.
- Cold exposure is linked to better temperature regulation and circulation in Long Covid patients.
- Many find it boosts mental clarity and provides a sense of vitality.
What they didn't like
- Overexposure can worsen symptoms or cause energy crashes in Long Covid patients.
- Risks include cold shock, hypothermia, or unsafe conditions like strong currents.
- Some patients report difficulty warming up after sessions, leading to discomfort.
- Hormonal fluctuations can make cold exposure unpredictable and less effective.
What are they unsure about
- Experts are uncertain about the ideal duration and frequency for Long Covid patients.
- The impact of hormonal changes on cold exposure's effectiveness is unclear.
- Long-term benefits for Long Covid recovery remain under-researched.
- Safety protocols for vulnerable patients need further refinement.
9 expert views
Expert view
Cold exposure can be a helpful tool for people recovering from Long Covid, but it needs to be done carefully and tailored to the individual. Anna Marsh explains that cold stress might be more suitable for those who struggle with post-exertional malaise or are overstimulated by heat stress. She advises starting with short durations, like a 10-second cold shower, and gradually increasing exposure. Safety measures, such as entering cold water slowly, having a buddy, and warming up afterward, are crucial. Marsh also mentions combining heat and cold exposure for advanced recovery stages, but emphasizes that this approach is intense and should be treated like an exercise session.
September 2024 • Chronic Fatigue and Burnout Recovery Podcast
Expert view
The expert discusses the use of cold exposure as a treatment for Long Covid and chronic fatigue. Cold exposure is described as a hormetic stressor, meaning it can create positive changes in the body when applied in small, controlled amounts. The recommended dosage is 11 minutes per week of uncomfortably cold but safe exposure, such as cold showers or ice baths. This can help improve cortisol levels, stress resilience, and circadian rhythm, which may support better sleep. However, overdoing it can stress the adrenal glands, so starting with shorter durations and gradually increasing is advised. Safety precautions, like avoiding cold shock or drowning, are emphasized.
September 2024 • Chronic Fatigue and Burnout Recovery Podcast
What and who it targets
Fatigue sufferers
May improve energy and reduce fatigue.
Chronic inflammation cases
Anti-inflammatory potential of cold exposure.
Brain fog patients
Potential cognitive clarity improvement.
Relevant research
How much evidence on this?
- Few studies directly link cold exposure to Long Covid.
- Research mostly focuses on Chronic Fatigue Syndrome (CFS).
- Studies span from 2021 to 2023, showing recent interest.
- Limited sample sizes and short follow-up periods.
Research focusing on
- Cold exposure may reduce fatigue and improve cognition.
- Effects on autonomic nervous system noted in CFS patients.
- Benefits may last up to one month post-treatment.
- Researchers exploring anti-inflammatory and neuroprotective effects.
What needs more research?
- Long-term effects of cold exposure remain unclear.
- Mechanisms behind symptom improvement need more study.
- Applicability to Long Covid specifically is uncertain.
- Optimal treatment protocols for cold exposure are undefined.
- ⬤ Minimal research: Very little scientific study exists, with no or very few peer-reviewed studies. Insufficient data for conclusions.
- ⬤⬤ Limited research: Few studies exist, mostly small trials or case reports. Findings are preliminary and lack strong validation.
- ⬤⬤⬤ Moderately researched: Multiple studies, including mid-sized trials, exist. Some findings are replicated, but more research is needed.
- ⬤⬤⬤⬤ Well-researched: Supported by substantial evidence, including at least one large trial or meta-analysis.
- ⬤⬤⬤⬤⬤ Extensively studied: Numerous large studies and meta-analyses exist. Findings are widely accepted with strong scientific consensus.
Research
This study explored how a combination of static stretching exercises and whole body cryotherapy (cold exposure) affected fatigue, daytime sleepiness, cognitive functioning, and the autonomic nervous system in people with Chronic Fatigue Syndrome (CFS). It involved 32 individuals with CFS and 18 healthy controls who participated in a two-week program with 10 sessions of these therapies.
The study found that the combination of stretching and cryotherapy significantly reduced fatigue in the CFS group. Additionally, some aspects of cognitive functioning, such as processing visual information and mental flexibility, improved in both the CFS and healthy control groups, and the therapy was well-tolerated.
For individuals with Long Covid experiencing similar symptoms to CFS, this study suggests that cold exposure combined with stretching exercises could help reduce fatigue and improve cognitive function. It also highlights the potential of cryotherapy as a safe and tolerable treatment option for managing these symptoms.
This clinical study was published in the reputable Journal of Translational Medicine, which adds credibility. However, the relatively small sample size and focus on CFS rather than Long Covid mean further research is needed to confirm its applicability to Long Covid patients.
June 2022 • Journal of translational medicine
Research
This study compared how fatigue, cognitive function, cardiovascular health, and the autonomic nervous system interact in Chronic Fatigue Syndrome (CFS) patients versus healthy individuals. Researchers measured these factors before and after 10 sessions of whole-body cryotherapy (WBC) combined with static-stretching exercises.
The study found that CFS patients had more significant disruptions in their body's balance (homeostasis) compared to healthy individuals. After the intervention, CFS patients showed a stronger link between fatigue, baroreceptor function (which helps regulate blood pressure), and aortic stiffness, while these connections were not observed in healthy participants.
For people with Long Covid or similar conditions like CFS, this study suggests that whole-body cryotherapy combined with stretching exercises might influence how fatigue and cardiovascular functions are connected. This could offer a potential avenue for managing symptoms, though more research is needed to confirm its effectiveness.
The study is moderately reliable as it was published in a reputable journal and included a control group. However, the sample size was relatively small, and the findings may not be directly applicable to Long Covid without further research.
July 2021 • Journal of clinical medicine
Accessibility
- ⬤ Extremely Difficult to Access: Rare, experimental, or highly specialized. Requires multiple referrals, long wait times, travel, and strict follow-up.
- ⬤⬤ Difficult to Access: Limited to select centers with moderate barriers. Requires referral, potential travel, and wait times of weeks to months.
- ⬤⬤⬤ Moderately Accessible: Available in larger hospitals or clinics. Requires a basic referral, with moderate wait times and some coordination.
- ⬤⬤⬤⬤ Easy to Access: Widely available in most clinics. Minimal referral, short wait times, and simple preparation or follow-up.
- ⬤⬤⬤⬤⬤ Trivial to Access: Easily found in pharmacies or clinics. No referral needed, minimal wait, and straightforward access.
- ⬤ Up to $100
- ⬤⬤ Up to $500
- ⬤⬤⬤ Up to $2000
- ⬤⬤⬤⬤ Up to $10,000
- ⬤⬤⬤⬤⬤ More than $10,000
Method to access
- Clinics offering cryotherapy or cold-water immersion provide professional cold exposure therapy.
- At-home options include ice baths, cold showers, or cold plunge tanks.
- No referral is required for at-home methods, but professional sessions may require consultation.
- Online booking is available for cryotherapy sessions.
Cost
- Cryotherapy sessions cost $40–$100 per session.
- Package deals for multiple sessions range from $200–$600.
- At-home setups like ice baths are inexpensive, requiring only ice and a container.
- Cold plunge tanks cost $9,500–$20,000 depending on features.
Insurance cover
- Cryotherapy is generally not covered by health insurance as it is considered alternative therapy.
- Some health savings accounts (HSAs) and flexible spending accounts (FSAs) may cover costs.
- Coverage varies by region and provider; consult your insurance for specifics.
Locations
- Boston Medical Center offers Long Covid care, including potential cold exposure therapy.
- Spero Clinic specializes in neurologic rehabilitation for Long Covid.
- Cryotherapy centers are widely available in urban areas.
- At-home options can be set up anywhere with basic equipment.
Frequently asked questions
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